Director, Special Investigations Unit Leader
2 days ago
As a Director, Special Investigations Unit, you will be responsible for leading the Life, Annuity & Health claims and fraud investigation programs and managing the Life Special Investigation Unit (SIU) staff. You will develop investigative and operational priorities, manage workload balance, develop staffing strategies, and evaluate operational results. You will also create and maintain industry, law enforcement, and other business relationships.
Key Responsibilities- Provides guidance to staff in interpreting procedures, guidelines, and training reference materials.
- Oversees decisions made within the claims and benefits process.
- Approves claims within assigned authority limit.
- Directs claim investigation team and ensures business performance and progress towards short and long-term CoSA/Corporate objectives.
- Develops and implements Claims Security strategic and operational plans/policies in conjunction with senior management.
- Identifies emerging fraud trends and develops new fraud investigation programs and processes.
- Responsible for communication and training strategies in support of new programs and processes.
- Regularly interacts with and influences peers and executive management on significant fraud and operational issues.
- Oversees process improvements in the Claims and Fraud investigation functions.
- Develops collaborative internal and external relationships with enterprise business partners, vendors, industry, governmental, and law enforcement agencies.
- Responsible for hiring, employee development, coaching, counseling, performance evaluation, and all management-related functions.
- Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.
- Bachelor's degree or 4 years of related experience (in addition to the minimum years of experience required) may be substituted in lieu of degree.
- 8 years of relevant business experience, including 3 years of Claims and/or Insurance Fraud experience.
- 3 years of direct team lead or management experience.
- US military experience through military service or a military spouse/domestic partner.
- 6 years of experience leading a Life Special Investigation or Fraud Program.
- Fundamental knowledge of advanced fraud analytics.
- 4 years of SIU Project Experience, including a broad understanding of procedures related to SIU investigations.
- Knowledge and experience in fraud waste and abuse investigations of Medicare Supplement Claims.
- Experience in life claims fraud or financial crimes investigations.
- Excellent communication, interpersonal, and problem-solving skills.
- Exceptional analytical and decision-making acumen.
- Certified Fraud Examiner (CFE) or Accredited Health Care Fraud Investigator (AHFI) designation is a plus.
USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position.
The actual salary for this role may vary by location.
The salary range for this position is $109,130 - $202,500.
Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.
At USAA, our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental, and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs.
For more details on our outstanding benefits, please visit our benefits page.
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